In 2021, we’ll begin to use concepts from the working room within the intensive-care unit (ICU). The Covid-19 pandemic has compelled us to rethink our understanding each of the human physique and of systemic medication. We now have seen that pathological inflammations in sufferers with the virus can seem wherever, and sufferers can current issues in any organ system, from easy fevers to main strokes. This has led to novel approaches regarding the therapies being tried in hospitals and conventional divisions between departments breaking down.
One instance is how we monitor sufferers who’re sedated. Sedation is a significant a part of treating an ICU affected person who wants a ventilator, simply as it’s of treating one in an working theatre. Up to now we’ve taken completely different approaches to monitoring how sedated a affected person is. In an working theatre, anaesthesiologists usually use electroencephalogram (EEG) recordings to observe a affected person’s degree of unconsciousness. In ICUs, nevertheless, clinicians usually have used medical assessments as an alternative.
This has modified below Covid-19. Through the pandemic, we’ve began to see extra requests for assist with EEG machines within the ICU to evaluate sufferers’ ranges of arousal. It’s because the virus impacts the whole lot, together with the mind, and an understanding of how a affected person’s mind is functioning is essential to offering the proper degree of sedation.
One key purpose that this sort of cross-pollination occurred, within the hospital I work in at the least, is that lots of the employees who have been redeployed throughout the pandemic after we have been attempting to maintain the whole lot working early within the yr, have been anesthesiologists, anaesthesia residents and anaesthesia nurses. In 2021, we’ll see extra trade of concepts like this between departments and different specialties. The pandemic has taught us the advantages of those new partnerships, and they’ll proceed within the months and years to come back.
In fact, these conversations have been ongoing amongst our communities from even earlier than the pandemic struck – however Covid-19 has accelerated the willingness of seasoned specialists to strive new approaches. In terms of utilizing EEG screens in ICU, there stay points round value and coaching. However these sorts of developments may herald a brand new age in our understanding of the techniques that comprise our our bodies and the way we devise efficient therapies, significantly after we discover ourselves working in resource-limited conditions that we’ve by no means been ready for.
Emery Brown is the Warren M Zapol prof. of anesthesia at Harvard Medical College and a practising anesthesiologist at Massachusetts Common Hospital
